改良3D打印阴道多通道非共面插植模板在宫颈癌术后阴道残端切缘阳性或肿瘤近切缘患者中的应用效果  

Application effect of improved 3D printing vaginal multi-channel non-coplanar implantation template in patients with positive resection margin of vaginal stump or tumor near resection margin after cervical cancer surgery

作　　者：冯成军 温晓敏 华丽[1] 陈绍俊[1] FENG Chengjun;WEN Xiaomin;HUA Li;CHEN Shaojun(Department of Oncology,the Fourth Affiliated Hospital of Guangxi Medical University(Liuzhou Worker’sHospital),Liuzhou 545005,Guangxi,China)

机构地区：[1]广西医科大学第四附属医院(柳州市工人医院)肿瘤科,广西柳州5450050

出　　处：《癌症进展》2024年第9期974-977,994,共5页Oncology Progress

基　　金：广西重点研发计划项目(桂科AB21196014);柳州市重点研发计划科技攻关与新产品试制项目(2018BJ10505)。

摘　　要：目的目的探讨改良3D打印阴道多通道非共面插植模板在宫颈癌术后阴道残端切缘阳性或肿瘤近切缘患者中的应用效果。方法方法选取43例宫颈癌术后阴道残端切缘阳性或肿瘤近切缘患者,根据治疗方法的不同分为改良插植组(n=21)和常规插植组(n=22),改良插植组术后接受同步调强放化疗联合改良3D打印阴道多通道非共面插植模板引导下的后装插植治疗,常规插植组术后接受同步调强放化疗联合常规阴道多通道共面插植模板引导下的后装插植治疗。比较两组患者靶区剂量参数[D90、D100、V100、V150、均匀性指数(HI)与适形指数(CI)]、危及器官受照剂量参数(D2cc、D1cc、D0.1cc)、放射不良反应发生情况和生存情况。结果结果改良插植组D90、D100、V100、CI、HI均高于常规插植组,膀胱和直肠D2cc、D1cc均低于常规插植组,局部无进展生存情况优于常规插植组,差异均有统计学意义(P﹤0.05);两组患者无进展生存情况、总生存情况及放射不良反应发生率比较,差异均无统计学意义(P﹥0.05)。结论结论与常规阴道多通道共面插植模板比较,改良3D打印阴道多通道非共面插植模板在宫颈癌术后阴道残端切缘阳性或肿瘤近切缘患者的后装插植治疗中靶区剂量分布更好,临床疗效更佳,且不会增加不良反应。Objective To investigate the application effect of improved 3D printing vaginal multi-channel non-copla-nar implantation template in patients with positive resection margin of vaginal stump or tumor near resection margin after cervical cancer surgery.Method A total of 43 patients with positive resection margin of vaginal stump or tumor near re-section margin after cervical cancer surgery were selected and divided into improved implantation group(n=21)and con-ventional implantation group(n=22)according to different treatment methods.The improved implantation group received synchronous intensive-modulated chemoradiotherapy combined with post-implantation therapy guided by improved 3D printing multi-channel non-coplanar implantation template.The conventional implantation group received synchronous in-tensive-modulated chemoradiotherapy combined with post-implantation therapy guided by conventional vaginal multi-channel coplanar implantation template.The target dose parameters[D90,D100,V100,V150,homogeneity index(HI)and con-formal index(CI)],dose parameters for organs at risk(D2cc,D1cc,D0.1cc),incidence of adverse radiation reactions and surviv-al were compared between the two groups.Result The D90,D100,V100,CI,HI in the improved implantation group were higher than those in the conventional implantation group,the D2cc and D1cc in bladder and rectum were lower than those in the conventional implantation group,the local progression-free survival was better than that in the conventional implanta-tion group,and the differences were statistically significant(P<0.05).There were no significant differences in progres-sion-free survival,overall survival and incidence of adverse radiation reactions between the two groups(P>0.05).ConcluConclu-sion Compared with the conventional vaginal multi-channel coplanar implantation template,the improved 3D printing vaginal multi-channel non-coplanar implantation template has better target dose distribution and clinical efficacy in post-implantation therapy for patients with positive resec

关 键 词：宫颈癌 后装插植治疗 阴道插植模板 3D打印 

分 类 号：R737.33[医药卫生—肿瘤]